The combination of TB, AIDS, and poverty in Cambodia is catastrophic. The country has the largest incidence of TB in the world, 539 new cases/100,000 individuals. TB is the leading cause of death among men between 15 and 49 years of age, the primary working population. The estimated rate of HIV-1 infection is the highest in Southeast Asia, and studies indicate that 3.7% of individuals between the ages of 15 and 49 are infected. The overall goal of this project is to establish a comprehensive program in Cambodia for prevention, therapy, and research on TB and AIDS. This program will build upon existing strengths of the Cambodian Health Committee's TB treatment and TB/AIDS prevention programs and extensive networks in two provinces in rural Cambodia. This program will also benefit from the extensive experience of the Medicines du Monde sponsored HIV/AIDS activities at the Calmette Hospital in urban Phnom Penh. Additionally, laboratory based support from the Institute Pasteur Cambodge, the Tuberculosis Research Section of NIAID will be leveraged with the ongoing Harvard Medical School's Center for Blood Research/Cambodian Health Committee research collaboration.
The Specific Aims of this Application are to establish a planning process to generate a proposal for a comprehensive, integrated program for HIV and TB prevention, therapy, and research. Specifically this proposal seeks to:1. coordinate clinical and research infrastructure for HIV and TB patient access in both rural and urban settings 2. coordinate efforts with national and regional governmental agencies responsible for TB and HIV control and treatment 3. formulate a research agenda on both TB and HIV that will build capacity for evaluation of novel vaccines and therapeutics while contributing insights into the fundamental pathogenesis of these diseases. We anticipate that this project will result in a proposal for an integrated, comprehensive research network in Cambodia for the development of novel approaches towards the treatment and prevention of HIV and tuberculosis in both rural and urban settings.
